Zygomatic implant placement, specifically the quad zygoma protocol, by which 4 implants give a boost to a set prosthesis in a seriously atrophic edentulous maxilla, stays one of the challenging packages of guided implant surgical procedure. That is because of the lengthy, angulated trajectories and the proximity of the orbit, cranium base and nasal hollow space.4 Dynamic navigation is these days probably the most widely documented guided modality for this software, and potential knowledge give a boost to its accuracy in full-arch zygomatic and standard implant placement for instant loading.4, 5 Process-autonomous robot placement of zygomatic implants has additionally been described, however the proof is at an early level and is in large part from in vitro and ex-vivo research, and case stories. A contemporary systematic evaluation highlighted the restricted proof base in comparison with that for typical implant placement.6
In contrast, a rising frame of scientific literature has evaluated the accuracy and effectiveness of task-autonomous robot methods for typical implant placement.7 Yakebot (Beijing Yakebot Era), a task-autonomous device that executes the deliberate osteotomy and implant placement below steady operator supervision, has been reported to reach considerably smaller platform, apical, intensity and angular deviations in comparison with totally guided static CAIS in edentulous jaws.8 A contemporary meta-analysis of robot CAIS trueness throughout scientific research reached identical conclusions.9
Recording the spatial courting of 4 extensively divergent zygomatic implant positions throughout a complete arch items a prosthetic registration problem that may be tough to regulate with typical impact ways, specifically when fast provisionalisation is needed. In a up to date potential scientific find out about, intra-oral photogrammetry enabled correct full-arch seize of implant positions and fast loading of a 3D-printed provisional prosthesis.10
This record describes a complete full-mouth rehabilitation by which two CAIS modalities along side photogrammetry had been mixed: dynamic navigation for zygomatic implant placement within the maxilla, task-autonomous robotics for typical implant placement within the mandible and intra-oral photogrammetry for fullarch fast provisionalisation. Every CAIS generation used to be matched to the anatomical traits of the arch by which it will be used, quite than making use of one CAIS modality uniformly.
Case presentation
A 59-year-old male affected person, who smoked roughly 5 to 10 cigarettes in step with day, offered with a closely restored and failing dentition in each arches. His scientific historical past integrated high blood pressure and hyperlipidaemia, controlled with amlodipine and simvastatin, respectively. He additionally reported taking omega-3, co-enzyme Q10 and glucosamine dietary supplements. His frame mass index used to be 28.6 kg/m² (78 kg; 1.65 m).
Medical exam printed bimaxillary protrusion, lack of posterior give a boost to, and anterior tooth compromised through recurrent caries and faulty steel–ceramic and forged restorations (Figs. 1a & b). Panoramic radiography and CBCT demonstrated in depth bilateral pneumatization of the maxillary sinuses, extending anteriorly to the central incisor area. A 3D digital affected person used to be created for prognosis and remedy making plans the use of knowledge from CBCT, intra-oral and facial scanning and dynamic jaw movement registration (SHINING 3D).
